COVID-19 has forced a myriad of changes to healthcare delivery, but none more compelling than the mainstreaming of telemedicine. Initially, the urgent necessity of connecting patients to providers without potentially exposing either party to the spreading virus drove a swift band-aid adoption of remote communication technology. Not surprisingly, challenges resulting from this rapid deployment quickly surfaced in the form of compromised security, transmission glitches, a utilization learning curve, limited hardware availability and a cumbersome user experience, among other difficulties. It was a classic “learn as you go” scenario.
In order to facilitate global telemedicine implementation, the government relaxed a number of category-killer restrictions that had been in place prior to the pandemic—most notably interstate treatment barriers and HIPAA data privacy oversight—as well as instituting payment parity with in-person visits. The end result was a broad adoption of the technology across all age groups, including the historically technology-challenged senior population. So, now with the emergency abating, the question is—where do we go from here?
It is now evident that telemedicine has become wildly popular with both patients and providers and has ushered in a new era of convenience and increased productivity. Initial concerns about overutilization and fraud have not materialized to any significant degree to date, and the technology shift has fostered new innovations that are improving patient outcomes. These are powerful arguments for continuing and expanding the use of telehealth services.
It remains to be seen if the market forces will result in long-term legislative and reimbursement changes to the system once the current period of regulatory relaxation and financial incentives expires. Although the jury is still out on this, most experts believe that the genie is out of the bottle. Accordingly, medical providers need to be thinking about building a long-term telemedicine strategy that replaces the reactionary band-aid solution(s) currently in place. In so doing, it is important to design a system that allows for flexibility to accommodate future growth, innovation, and utility. To this end, let’s examine some of the current and emerging uses and benefits of telemedicine:
• Decreased Infection Exposure: This holds true for the current pandemic, future outbreaks, and the seasonal flu. It reduces the petri dish scenario in hospitals and medical offices, as well as public forums such as mass transit environments.
• Improved Patient Scheduling and Throughput: Typically, more patients can be seen in a given period of time leveraging this technology, and patient no-shows are both minimized and less disruptive when they occur. Further, patient wait times are markedly decreased (reducing backups), and providers can optimize their time by consulting from any location (including when they are in transit). Lastly, whenever physical visits are needed, patients can be directed to the appropriate provider, as opposed to having them choose the emergency room, which is a money drain for the hospital.
• Better Capacity Management: A decrease in physical visits means less office space and resources needed.
• Improved Chronic Disease Management: Remote patient monitoring of vital signs, glucose levels, weight, etc. enables providers to preempt emerging health problems for chronically ill patients. The number and expanded utility of tech innovations that provide at-home diagnostics are rapidly accelerating—and we’ll be discussing them here in a future post.
• Critical Care Management (eICU): Feeding patient telemetry and video into the inter/intranet allows for a central monitoring process, which in turn yields greater efficiency and the ability to redeploy staff. The most compelling use cases are related to critical care and stroke patients.
• Integration and Analytics of Patient Fitness Data: Access to patient fitness data from a smart watch or smartphone enables a retrospective view of heart rate, BP, and sleep patterns, which lends valuable historical insight leading up to a medical event.
• Improved Provider Collaboration: Multiparty video connectivity, shared white boards, real-time data exchange, and mobile access enhance the provider collaborative experience. Further, the technology breaks down geographic barriers and time zone differences through the integration of efficient scheduling and language translation options.
• Inexpensive Geographic Expansion: Telemedicine enables multifactorial interaction between provider and patient, ranging from simple video visits to providing satellite office care through the use of diagnostic equipment and a nurse or PA at the remote site. Consequently, a hospital could penetrate new service areas without the costs of building a new facility. As the technology curve advances, one could imagine robotic surgical procedures being performed remotely by a top surgeon, with support personnel situated locally. Another compelling efficiency is the ability to conduct remote second opinions for cancer, saving the patient the trouble and expense of scheduling and travel to a far-off facility.
A well-planned telemedicine solution should have the flexibility to accommodate the above use cases, and have a stable, efficient, secure, and user-friendly platform that is integrated with the institution’s EHR system. Other important considerations are the ability to seamlessly integrate diagnostic and remote monitoring equipment, process credit card payments, provide scheduling capability, offer virtual waiting rooms, verify insurance coverage, provide store-and-forward capability, and enable language-translation integration. Certainly, there’s a lot to think about, but as history has consistently shown, good fortune always favors the well-prepared.